If an employee is injured at work, an Ohio University Employee Injury/Illness/Incident Report Form MUST be completed within 24 hours of the incident. If the injured worker is unable to complete the form, his/her immediate supervisor must do so to the best of his/her knowledge.
The employee may seek treatment at University Medical Associates (UMA) or the local Emergency Department. However, the injured worker has the right to select the physician or medical facility he/she desires as long as they are BWC certified, if more than one visit is required.
In order to file a claim, a First Report of Injury (FROI) must be completed and filed with Ohio University's Third Party Administrator (TPA) CCI, Inc. Let the medical facility know that Ohio University's TPA is CCI, so they can file the FROI. An injured worker has two years from the date of injury to file a Workers' Comp. Claim, but only has 24 hours to submit the OU Incident Report Form.
Please remember that the First Report of Injury form that is completed at the physician's office or hospital is NOT the same form as the Ohio University Employee Injury/Illness/Incident Report Form. This form needs to be completed immediately and turned in to the: Workers Compensation Administration Department, University Center #276, Attention: Marilyn McVey, in order to prevent any delays in your workers compensation claim.
Once a claim has been submitted to the University's TPA, the injured worker will begin to receive paperwork via postal mail regarding the claim. The paperwork will provide important information such as claim number, claims examiner, general information, etc. A claim will be designated as "medical only" or "lost time."
A medical only claim is if the injured worker missed 0-7 days (calendar days, not business days) of work. A lost time claim is when 8 or more consecutive days of work are missed.
If an injured worker missed 8-13 consecutive days of work, he/she may be eligible to receive lost wages for days 8-13 only. If the injured worker missed 14 consecutive days of work, he/she may be eligible to receive wages from the first day forward of missed work. Lost wages will only be paid (if it is an allowed claim) if the following types of time are used during the injured workers absence:
- comp. time,
- personal time and/or
- leave without pay.
Lost wages will NOTbe paid to an injured worker if SICK TIME was used during the leave. The injured worker may use any type of time while on leave (if applicable).
Again, the lost wages will NOTbe paid if SICK TIME has been used; however, the injured worker may use sick time if he/she desires.
A claim will either be allowed or disallowed. If an employee disagrees with a decision, that employee may file an appeal with BWC. If it is a medical only claim and it is allowed, the medical bills will be reviewed and paid by CCI. If a claim is disallowed, the injured worker has 14 days from the day he/she received the order to submit an appeal in writing to BWC. Failure to submit an appeal within the time frame will result in permanent disallowance of the claim. The injured worker will receive written notification of the date, time, and place the appeal will be heard.
If the injured worker and their medical doctor feel that the employee cannot return to work, the employee MUST obtain a doctor's note to include the following:
- date(s) to be off work,
- diagnosis (why taking off work),
- restrictions (if any) and
- estimated return to work.
The employee MUST return through the University Medical Associates (UMA) and provide the appropriate medical documentation from their physician that they are capable of returning to work.